[Editor's Note: The work session lasted more than four hours and the regular session almost 3 ½ hours, so there will be multiple articles on the two meetings. Although some reporting will be summarized rather than the usual full reporting of every comment and remark.]

By Mary Alice Murphy

The Grant County Commission met in work session on Tuesday, June 16, 2020. With no public input, the first item addressed was a presentation by the Juvenile Advisory Board on their programs by Bianca Padilla and Gary Stailey.

"I will report on the programs that the county oversees," Padilla said. "We started the advisory board in 1997, as the first continuum site in New Mexico. It's now 23 years old. The Children, Youth and Families Department funding in 1997 focused on the adult system. We began to work with juveniles, with about 110 coming in every month."

Stailey said the first charge for the board was adults, but "we looked at state code and it was supposed to focus on early intervention. That's how we started working with schools, so juveniles were not always in crisis or part of a conveyor system. The programs weren't perfect, but the community worked together. We wanted to work on prevention. We are part of District 6, and we are working with the county, the city and the schools."

Padilla said the group works on eight programs and focuses on key areas. "Our programs are based on community needs. We are working with the JPPO (Juvenile Probation and Parole Office) and, if it's child abuse, with Child Protective Services. I was in both, so that's why this is my passion. We saw the need for job skills training and strengthening families. In the Strengthening Families Program, we break into groups, with the kids in one group and the parents in another. Then we get the two groups together to talk about what they learned. It's a meaningful program that we're still building. The Youth Development program started at The Volunteer Center under Commissioner Alicia Edwards, when she was director of it. Gary manages that program and you see the results with the flower boxes downtown, sidewalk art, the butterfly garden and downtown banners. They were working on the Big Ditch with the YCC (Youth Conservation Corps). Right now, they are working at home, building birdhouses and gardens with their families.

"The last program is the Learning Lab," Padilla continued. "We had a need to continue the education of those who were suspended or expelled from school. It is for grades 6-12. From 8 a.m. to 2 p.m., we work with them in a safe setting. The support is provided by Silver Schools, so the students can continue their education and when they go back not be behind their peers. Twenty-three years later, a lot of hard crime has been decreased in the county. For the past five years, we are down 40 percent to 77 percent depending on the crime, because we focus on prevention to keep them out of the juvenile system. We have developed a lot of partnerships. Grant County is our fiscal agent and has been very supportive. Silver City is also amazing, in addition to Silver Schools. They are natural partners. Now we have only about 15 a month coming in, so we are down 80 percent to 90 percent. Detention is now basically non-existent, with only one or two a month."

Padilla said she is really passionate about "what we do. We've adapted during the coronavirus with Zoom and phone calls. We are still supporting the kids. In the future, we will resume the in-person services."

She rapidly read the mission statement, which included strengthening families.

Edwards thanked Padilla and Stailey for "your incredible work. It is stunning to see the data of improvements."

Stailey said it may appear like kids are not being held accountable, "But these kids are finishing their probation and these youth are individually responsible for any damages. They are held accountable in a positive way. People who work with them ask me: 'Who are these kids?' When I tell them they are on probation, they are amazed because the kids are so respectful."

Padilla said they have grown their budget to more than a quarter of a million dollars. "We do drug and awareness counseling. We do recreational art and are always focusing on prevention. We used to average 40 percent of the youths. If we keep doing it, we will make a difference."

Stailey said only a few are actually delinquent. "We're preventing delinquency."

District 5 Commissioner Harry Browne expressed his deep gratitude. "It is a great pleasure to hear about these successful programs. You're a couple of decades ahead of Corrections. When you engage them in community, you are turning them into responsible citizens."

The next presentation was from Ted Martinez of the Treasurer's Office giving the commissioners an overview of the delinquent solid waste payment that are subject to lien. "I sent out 180 letters starting on March 18, reminding them of being delinquent and subject to lien. We have collected $110,000, not counting those paid with credit card. Only 69 of the 180 are left."

The next presentation was the annual Assessor's report, given by Chief Deputy Assessor Matthew James. His PowerPoint presentation consisted of many data tables on 2019 results. He started with 2019 by the numbers—Residential sales, which he said gives data to the department.

"The sales ratio equals the appraised value divided by the sales price," James. "That lets us know how well we are appraising. We are doing very well, meeting all standards."

Although most of the land in Grant County is residential, and 0.14 percent of all land is commercial, 0.35 percent of taxable land is commercial.

He noted that building permits went up 11 percent last year. "The trouble with permits is that last year the CID (Construction Industries Department) was not functioning for about six months, so 28 percent were not closed last year. Most of our permits go through the Las Cruces office. Manufactured homes are a considerable part of our activity. They were up 12 percent last year, but volume is down."

Protests were higher in 2019 at 171 but are "way down this year at 74 received. Probably because the office is closed. The entire process can be done by email, but a good number want to do it face-to-face. Last year the percentage was 0.6 percent of tax bills, but this year it was only 0.3 percent."

James said agriculture, grazing and livestock are fairly flat year over year, with the livestock head count down, and the rates are down.

"We have a 5 percent non-reporting fee, and probably take in $10,000 to $12,000 annually for non-reporting," he said.

As for personal property, "we have an increasing number of accounts, but limited capacity to do force reporting, so there is a lot of under-reporting."

With title examination, he said the department has no control over the number of documents.

On new exemptions processed, last year saw an uptick in fully disabled veterans. "We don't know if that will hold this year."

He talked about the re-inspection plan, with field work and data entry. "We began a six-year cycle for canvassing 100 percent of county parcels in FY 2019-20. It requires 2.6 appraisers dedicated fulltime to the task. But between March and June 1 this year, we have had limited field visits. Our annual goal is about 2,000 per six months."

He cited inadequate staffing, with a frozen temporary position and the suspension of field visits during the stay-at-home order as obstacles.

"We need to move toward statistical mass appraisal, so we are getting our database up-to-date," James said. "We hope to finish inputting historical data and putting in new. We have had to correct some wrong data."

He said sales affidavits are not required for vacant land. Other obstacles to completing the database include neighborhoods not being defined, statistical models not development and land value data being out of date.

James briefly addressed the parcel mapping correction progress, with 221 subdivisions having ben completely redrawn to original subdivision measurements. Subdivisions are being quality controlled and noted with adjustments to aerial imagery. The data is clean and both tax parcels and redrawn subdivisions have been successfully changed to a parcel fabric.

He said the project Phase One is 98 percent complete. "When complete on June 15, the most populated areas of the county will be accurate. Areas outside of subdivisions will still remain, some with the most alarming offsets."

Phase Two will address the remaining 34.5 percent of assessor accounts, at an estimated cost of $135,000.

One table presented the net assessed value, which James said will not be certified until about July 15. "We had, in the county, growth in the residential and overall last year at about $4 million. Net new is a way for the county to generate new revenue. 2019 was a great year for net new, because it included the senior housing above AutoZone. If we get more value, it generally creates lower rates."

A table showed copper value. "That is a state asset, and the state assesses it, so we don't have it until we are given the numbers," James said.

At the regular meeting on June 18, 2020, commissioners heard the monthly report from Gila Regional Medical Center, with Interim Chief Executive Officer Scott Manis beginning the report.

"We have had 16 cases of covid-19 overall," Manis said. "We are in constant contact with the state, with the New Mexico Hospital Association and the Southwest Regional Hospital Association. Testing continues to be available at the Family Medical Clinic by appointment. We are continuing to restrict visitation to the hospital, but we are working, along with other hospitals, on a plan to loosen up visitation restrictions. We are tapping the brakes on student rotations, and we are watching carefully from a ramping back up standpoint. We have started slowly on elective surgeries and other procedures. It is safe to get procedures done, and frankly we could use the volume.

"We had the Joint Commission survey done last week virtually for the critical access designation," Manis continued. "Overall we did very well. It was a bit of a challenge, but we got it done. The Joint Commission will send two surveyors onsite within the next few weeks. We have a plan of correction on the findings, with some already addressed and others that we are aggressively addressing. The next steps are creating a timeline for all of the rest that needs to be done. We have a firm date of June 15 as our designation to work outward from. Once our plan of corrections is submitted, then the designation is effectively June 15. We are also well on our way to the Rural Health Clinic designation for our Family Medicine Clinic. We expect the survey soon. If we are in substantial compliance, it will be much of the same process as the hospital. We will have to change our provider number for all vendors and contracts."

He also addressed the Behavioral Health Unit. "The Governing Board of the hospital suspended the services, so that we could meet Joint Commission survey requirements, as we don't have an on-staff psychiatrist right now. We do have continuing consultation for emergency psychiatry in the Emergency Room. We're working on finding the most appropriate facility for capability and capacity to accept patients that need in-hospital care. They are now being transferred to other facilities. The Governing Board will be evaluating the future for the BHU."

Vitalant is the company that provides blood supplies to the hospital. "Right now, there is not much blood supply available," Manis said. "Vitalant is asking us to watch our inventories. If you're a regular blood donor, please do find the opportunity to donate."

Edwards asked what the options were for someone wanting to donate.

Manis said there have been a few donation opportunities, one he knew of at a local church. "We are thinking about doing one within the hospital staff. We need to find out the schedule for other potential donation sites."

District 4 Commissioner Billy Billings said one did happen at Harvest Church.

Edwards suggested one in the county parking lot for county employees.

District 1 Commissioner Javier "Harvey" Salas asked when the reimbursements at critical status level would begin.

"We have to get the provider number and change all the contracts," Manis said. "It will ultimately be in place around January 1, maybe a little bit earlier or later. June 15 is our actual date, so we will look back and true up all accounts from June 15, but we may not get the payment until January."

Salas also asked what the process would be if a person went to the ER with an eye problem and if there is an ophthalmologist here.

"Dr. (Nicholas) Mittica is the ophthalmologist in the community," Manis said. "If the eye problem is deemed an emergency, we will follow guidelines. Dr. Mittica may be able to deal with it or we will find the facility with the capability and the capacity to transfer the patient to."

Browne asked if the hospital is done fixing the charge sheet as of June 15. "That will help us figure out an estimate on anticipated revenue under critical access."

"We are working on the Charge Master with a third-party consultant to establish the rates," Manis said. "Another positive thing I wanted to mention is the Community Paramedicine Program. The Emergency Medical Services (EMS) staff has partnered with Blue Cross/Blue Shield to go out and make home visits to cut down on hospital visits. They have done 30 so far and already have 23 more referrals. They do the home visits and Blue Cross/Blue Shield pays us for them. We are still reaching out to other insurance vendors for contracts to do the same services for them."

Edwards noted that the RHC designation also improves reimbursement levels. "What is the timeline for that?"

Manis said it will also take some time, because of the need to get the provider number to give to insurance companies.

GRMC Chief Financial Officer Richard Stokes said he wanted to emphasize that people need to come to the hospital if they need to. "I was on a call with other hospitals and one mentioned a 30-something-year-old, who waited too long to go to the hospital and did not survive. That was in another community. Please, if you need to, come to the hospital. We're probably the safest place to come."

He then gave a brief financial report. "For April, we lost $4.4 million. For April 2019 we had revenue of $5 .9 million. This year, we had $1.4 million. Like most hospitals across the state and country, we are seeing decreased activity at the hospital. Our balance includes the $2.2 million loan that we got from the Payroll Protection Program. We will attest to how we used it. In July, we are requesting that it be converted from a loan by turning it into a grant, and that we have qualified for it to be a grant. We have been in conversation with our external auditors and they are confirming that the way we have it on the books is the proper way. When it is turned into a grant, it will be retroactive to the 2020 fiscal year. But until we get the piece of paper saying it is forgiven, it will sit on the balance sheet."

Stokes said the loss year-to-date is $12 million. "We've definitely taken a hit die to revenue losses. Prior to Covid, we had revenue cash collections in the first 10 months of the fiscal year that had totaled what we received in the entire year last year, so we were doing well. But we are picking up speed. People are coming back to the hospital, and we thank you for that."

He then addressed the critical access issue. "As Scott said, it is complex, especially for billing. Our consultants have given us a proposed cleanup to the Charge Master. We plan to make it effective on July 1. That's the easy part. Medicare will give us a new provider number and a new NPI (national provider identifier) number. Then we have to contact all our insurance companies and we have to recredential all our providers, both for critical access and rural health clinic designations. We've been working on that process, so we are ready when we get the numbers."

Browne asked if there were anyone who would not be recredentialed.

"No, it's just paperwork," Stokes replied. "It's payer enrollment. We know what to do. We will also be engaging with the consultant for critical access and he will be giving us monthly reports. We want to make sure at the end of the year, not to have a payback or a large receivable."

Asked about Medicare users, Stokes said: "We did a survey and 86 percent of them have secondary insurance, so extra costs will be picked up by the secondary insurance. About 14 percent to 15 percent of our Medicare users will have somewhat increased costs."

The next article will begin with the review of the regular meeting agenda and will indicate which agenda items were approved.